Feature Health Reform

Poland’s painful market reforms

BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c2837 (Published 15 June 2010) Cite this as: BMJ 2010;340:c2837
  1. Peggy Watson, senior research associate
  1. 1Department of Sociology, University of Cambridge, Cambridge
  1. pw125{at}cam.ac.uk

    The death of the Polish president has put the mass commercialisation of the country’s hospitals back on the agenda. As new elections approach, Peggy Watson reports on the difficult course of health reform

    News of US health reforms dominated the international media earlier in this year, yet the equally contentious reforms taking place throughout post-communist Europe have been virtually ignored. In Poland, the largest of these countries, reforms have contributed to a new healthcare divide by hitting the people who most need health care the hardest—a situation now exacerbated by the financial crisis. A critical struggle has centred on compulsory commercialisation of hospitals. The move was vetoed by late president Lech Kaczyński, who was killed in an air crash in April. The fate of the reform hangs on the outcome of the presidential election set for 20 June.

    Post-communist countries of Europe have seen dramatic transformation in healthcare systems with a move away from socialised medicine to the introduction of capitalism. The changes—the break-up of central state structures, the introduction of the market and private health insurance, coupled with the propagation of the idea of individual responsibility for health—have been dictated by principles laid down by the World Bank. But dissatisfaction has been intense. Although Poland has not witnessed the violent protests that were seen on the streets of Lithuania, Latvia, Bulgaria, and Romania early last year,1 there is considerable discontent. In a recent Eurobarometer survey, 67% of respondents in Poland rated their national care as “fairly or very bad”—only Greece and Hungary had higher …

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